急性外伤性硬膜外小血肿积极手术的临床意义

Clinical significance of early operation in the treatment of traumatic acute small extradural hematoma

目的 :探讨急性外伤性硬膜外小血肿积极手术治疗的临床意义。方法 :分析我院救治的 65例外伤性急性硬膜外小血肿 ,其中超早期手术组 2 8例 ,保守治疗组 37例 ,用脱水剂、脑细胞营养药物等对症治疗。结果 :手术组 2 8例无 1例死亡 ,平均住院时间 (1 4± 4 .5)天 ,自觉症状缓解时间为 (1 0± 3 .5)天。保守治疗组因血肿扩大 ,突发脑疝来不及抢救 ,死亡 3例 ;因血肿扩大改用手术治疗 4例 ,平均住院时间 (2 1± 6 .5)天 ,自觉症状缓解时间为 (1 8± 4 .5)天。两组差异均有显著性 (P <0 .0 0 1 )。结论 :急性外伤性硬膜外小血肿超早期手术能避免因血肿扩大引起脑疝和死亡 ,自觉症状缓解快 ,住院时间短。

Objective:To discuss the clinical significance of early operation in the treatment of traumatic acute small extradural hematoma.Methods:Sixty five patients with traumatic acute small extradurl hematoma treated in our hospital from January 1995 to December 1999 were retrospectively studied.Twenty eight patients underwent early operation and 37 patients were managed conservatively.Results:No one died among the 28 patinets who underwent early operation and the mean length of stay was 14.5±4.5 days.In the conservatively managed group,three patients died due to quickly increased extradural hematoma and the mean length of stay was 21±6.5 days.Conclusions:Early operation is a safe and effective way for the treatment of traumatic acute small extradurl hematoma,which can avoid cerebral hernia caused by gradually increased extradural hematoma.